Half of drugs in cancer fund risk being cut

12,000 patients could miss out on treatment as funding is reviewed

CANCER drugs taken by more than 12,000 patients a year could be dropped by the NHS after a shake- up of the system was approved last night.

The medicines rationing body NICE is to reassess all 47 treatments available through the Cancer Drugs Fund, which is to be taken over by the regulator after its costs escalated.

However NICE employs a tough costbenefit threshold, and experts fear that 23 treatments previously turned down by the regulator could be refused again.

The move – which experts warn will set cancer treatment ‘back by a generation’ – is part of a reform of the £400million fund, which has come under pressure due to overwhelming demand.

NHS medical director Sir Bruce Keogh, who drew up the plans, said pharmaceutical companies could easily make the drugs available by simply dropping their price. But critics say his proposals are too rigid for the state of modern medicine, and will cause patients to miss out.

Andrew Wilson, chief executive of the Rarer Cancers Foundation, said last night: ‘The Government needs to come clean about the impact that these reforms will have.

‘There is a danger that these proposals could turn back the clock on cancer treatment, returning the NHS to the days where the majority of new treatments were denied to people who needed them most.’

The CDF was launched in 2010 to pay for medicines not routinely approved by NICE. Initially its budget was capped at £175million a year, but this soared to £416million as demand grew. Now NICE is to take control of the drugs in a drive to rein in spending.

However the regulator has not updated its rules for drug evaluation in over a decade.

Decisions are based on the cost of giving patients an extra ‘ quality’ year of life – with funding turned down if it is deemed to be above £30,000, or £50,000 for the seriously ill. Critics say the system has not moved with the times, with targeted, gene-based drugs now often costing over £70,000.

Some 23 of the 47 treatments currently available through the CDF have in the past been judged not cost effective by NICE either in draft or final guidance. It is estimated that 12,026 patients would receive these treatments in 2015/16, were no changes to be made.

Officials insist that any patient already taking a treatment available through the CDF will continue to receive their medicine. Funding will also continue for new patients until NICE has re-assessed the drugs.

The plans, approved by the NHS England Board last night, will also mean that patients receive treatments ‘with genuine promise’ during a two-year evidence collection period. They will also get quicker access to new drugs, with interim funding decisions made on the same day treatments are deemed safe.

While this aspect of the shake-up has been welcomed, experts are worried that fewer drugs will get through the assessment process.

Danni Manzi, of the Breast Cancer Care charity, said: ‘We are extremely concerned about the future for people with incurable breast cancer – we fear the four invaluable breast cancer drugs currently available on the CDF are at risk of being axed. Any changes will have life- changing implications.’ Baroness Delyth Morgan, of Breast Cancer Now, added: ‘It is indefensible that the CDF’s successor may actually result in fewer drugs being made available to patients.’

Dr Paul Catchpole, of the Association of the British Pharmaceutical Industry, said drugs firms were also disappointed by the plans and that ‘substantial change is needed to how medicines are appraised’.

But a spokesman for NHS England said: ‘Drug companies need to price their drugs responsibly and we make no apology for maintaining the pressure on this point.’

NHS England stressed that it was not possible to second guess the outcome of the NICE re-appraisals and said estimates as to the number of patients affected were mere speculation.

‘Come clean about the impact’